Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 170838006
- Reason
- Allergic disposition609328004
- Start
- 2020-04-12
- Stop
- 2020-04-12
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-9d68-e469bd03f131